Table 4.
Comparison of randomized double-blind controlled trials of bone change in postmenopausal women with osteoporosis comparing combined estrogen [Conjugated Equine Estrogen (CEE) or Estradiol (E2)] plus progesterone or medroxyprogesterone (MPA) and documenting percentage (%) change per year in Bone Mineral Density.
| Author | Type | Number | Age ± SD | Bone sites | Years | Anti-resorptive mg/d | Progesterone/ MPA mg/d |
Number | Combined % bone change | Number | Anti-R* % bone change |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Gallagher 1991 [84] | RCT not blinded | 81 | 52 ± 4 | DPA L2−4 SPA |
2 | 0.3 CEE 23/28 days |
MPA 10 mg 23/28 days |
16 | Spine +0.25 | 18 | Spine +1.0 |
| Radius | Radius +0.0 | Radius −0.05 | |||||||||
| PEPI 1996 [89] | DB-RCT | 875 | 56 | DXA L2−4 |
3 | CEE 0.625 | MPA 2.5 mg/d | 174 | Spine +1.6 | 175 | Spine +1.4 |
| Total Hip (TH) | 174 | TH +0.5 | 175 | TH +0.5 | |||||||
| Adachi 1997 [91] | DB-RCT | 98 | 54 | DPA | 1 | CEE 0.625 | MPA 10 mg for 15 d/mo. | 33 | Spine +2.7 | 34 | Spine +1.9 |
| Lindsay 2002 [90] | DB-RCT | 695 | 58 | L2−4 DXA |
2 | CEE 0.625 | MPA 2.5 mg/d | 81 | Spine +1.7 | 84 | Spine +1.2 |
| Total Hip (TH) | TH +1.3 | TH +1.4 | |||||||||
| CEE 0.45 | MPA 2.5 mg/d | 87 | Spine +1.5 | 91 | Spine +1.1 | ||||||
| TH +1.1 | TH +1.0 | ||||||||||
| Liu 2005 [87] | DB-RCT | 132 | 53 | DXA L2−4 |
2 | E2 1 mg/d | MPA 10 mg/d | 20 | Spine +2.3 | 23 | Spine +1.3 |
| FN | OME# | FN +0.9 | FN +1.0 | ||||||||
|
| |||||||||||
| 330 | Spine +1.7 | 425 | Spine +1.3 | ||||||||
∙DPA: dual photon absorptiometry, SPA: single photon absorptiometry, DXA: dual energy X-ray absorptiometry.
*Anti-R: antiresorptive therapy, #OME: oral micronized estradiol.
Note that the two estrogen-dose arms of the Lindsay study were considered as two different studies in the mean spine bone change.